Allergic Bronchitis Research Articles

アレルギー性気管支炎(喘息前段階)知見補遺

アレルギー性気管支炎(喘息前段階)知見補遺

IgE-hypersensitivity to allergens of the fungi Rhizopus Nigricans and Cladosporium Herbarum in childrenwith respiratory allergies

A survey of 111 children diagnosed with respiratory allergies (allergic rhinitis, allergic bronchitis, obstructive bronchitis, recurrent bronchitis, bronchial asthma) aged 1 year to 17 years, of which 58 children have a diagnosis of atopic bronchial asthma of different severity. All children are at risk for the development of fungal sensitization, having a household contact with these allergens. Allergological diagnostics was performed by ELISA using a panel of pediatric and fungal (Rhizopus nigricans and Cladosporium herbarum) biotinylated allergens. As a result of the study revealed that allergens mold Rhizopus nigricans and Cladosporium herbarum are the causal significant factor in the development of respiratory allergies, including asthma, in children at risk. Most often a high level of hypersensivity to Rhizopus nigricans is seen in children aged 2-5 years, Cladosporium herbarum - aged 6-9 years, concomitant to both fungal allergens at the age of 10-17 years. The correlation between the severity of atopic process and degree of sensitization to fungal allergens was not detected. All children with atopic asthma have polyvalent sensitization. Allergens mold Rhizopus nigricans and Cladosporium herbarum must be taken into account in the preparation of a diagnostic panel for children with respiratory allergies at risk. It is necessary to support drug therapy of respiratory allergy in children the activities aimed at elimination of cause significant fungal sensitization everyday surroundings.

Pathogenetic role in the allergic anamnesis development bronchitis in children

Actuality in the structure of general morbidity of children, potential allergic markers of risk of developing bronchitis. The main group consisted of 62 children age from 1 to 6 years with obstructive and nonobstructive bronchitis. As a result of research it is established that allergies the first year of life increases the probability of developing obstructive bronchitis.

Sensitization Prevalence of Asthmatic Children to Airborne and Food Allergens in Sakarya Province of Turkey

cat/dog; mold allergy: Alternaria/Cladosporium; grass pollen allergy: meadow fescue, nettle, mugwort, fathen, weed mix, cereal mix and grass mix; tree pollen allergy: cypress, ash, pine and olive; for food allergy testing: cow’s milk, egg, peanut, hazelnut and fish extracts were utilized. Skin prick test evaluation criteria are as follows: Histamine response (as positive control) and equal positive response to histamine were accepted as (3+). 3+ responses to any allergen extract is assumed to be significant sensitization. Results: In overall; 864/1311 (65.9%) children showed ≥ (3) response. According to 864 patients’ evaluation: there were ≥ (3) sensitizations to pollen groups (349/864: 40%); mites group (332/864: 38.4%); grasses (277/864: 32%); trees (72/864: 8.3%); molds (75/864: 8.6%); animals (49/864: 5.7%) and foods (59/864: 6.8%). In patients allergic to grass pollens: there were ≥ (3) sensitizations to English plantain (23%), grassen (23%), meadow (19%), nettle (24%) and mugwort (10%). In children allergic to tree pollens: there were ≥ (3) sensitizations to pine (39%), olive (38%), ash (16%) and cypress (7%). Conclusion: As expected, there were significant allergies mostly to pollens and mites in allergic bronchitis patients. Also, low overall sensitization rate (<%10 to molds) is of interest in our patients whom referred to us from humid Sakarya province. Similarly, there was somewhat low sensitization rate to house dust mite allergen when compared to other humid regions in Turkey.

Quality of Human Resources in Organized and Unorganized Sectors with Special Reference to Health Issue Management of Working Women

To be born a woman means to be a caregiver, from early infancy to the last day of life. But with changing times the role of woman has changed from a caregiver to a multitasking professional. A woman's life involves constant juggling between multiple responsibilities at home, meetings schedules, business trips at work, and responsibilities of life and family. Education developed a vision to prompt women to go for an occupation of their choice beyond the safety of home to lending service to the public. The migrationof a woman from her home to the professional career oriented work domain has given her respect and improved the standards of her quality of life. But at the same time, a woman plays the role of mother and home maker for family members bearing additional load of her occupation. The contribution of women to the national economy needs to be recognized for assuring them better living conditions. Their health issues, both mental as well as physical should be addressed as they are physically less strong than theirmale counterparts. This makes them victims of headache, osteoporosis, backache, joint pains, muscular skeletal disorders, arthritis and so on. Adding to the natural physical challenge, is the repetitive nature of the work causing boredom and the disproportionate earning compared to their male counterparts, which puts women under psychological stress and strain. Stress reflects in insomnia, fatigue, anxiety, headaches, heart trouble, alcoholism, drug addiction and abuse in extreme conditions. Women entrepreneurs oremployees due to sustained stress of their dual role (home and office) over years develop physiological conditioning and low immune profile because of inadequate personal attention detrimental by ill-health. Women working outdoors have exposure to airpollution, urban vehicular and exhaust fumes cause severe respiratory problems and pulmonary diseases. Agricultural women workers too face parasitic infections, allergic bronchitis, lung infection due to dust and unhealthy work environment. Women continueto suffer social constraints of societal dominant cultures, limited mobility and, in some cultures, they are thus negated any type of paid employment. At work, they may face verbal, sexual and physical abuse at an extreme end and at a common level they face gossip and stigma within their own communities. The growing levels and extremes of violence against women have been ‘femicide’-the killing of women by men just for being women, including ‘honor killings’ to reflect the psyche of the male dominanceand power to control and exploit the women. Such are the social and health issues of women especially working women in organized and unorganized sectors, which need to be addressed for the Indian society to be a humane civilization.

Lymphoid hyperplasia of the colon and its association with underlying allergic airway diseases.

The purpose of this study was to determine the prevalence of lymphoid hyperplasia in the lower gastrointestinal tract and its role in patients undergoing colonoscopic examinations, particularly focusing on any allergic predisposition. A database search performed at the Department of Gastroenterology at Onomichi Municipal Hospital identified seven patients with lymphoid hyperplasia in the large intestine (i.e., cecum, colon, and/or rectum). Data regarding the endoscopic, biological, and pathological examinations performed and the allergic histories for each patient were retrospectively reviewed from the clinical records. Median age of the patients (four males, three females) was 50 years. Lymphoid hyperplasia was seen in the cecum (n = 5), ascending colon (n = 2), and transverse colon (n = 1). Six patients (85.7%) had one of the allergic airway diseases: allergic rhinoconjunctivitis for pollen (n = 3), bronchial asthma (n = 1), infantile asthma (n = 1), or allergic bronchitis (n = 1). Drug allergy (n = 3) and urticaria (n = 2) were also found. All seven patients had one or more allergic diseases; however, none had a history of food allergy. Blood tests for allergens revealed that six patients (85.7%) had positive reactions to inherent allergens, whereas only one patient had a positive reaction to food allergens. Our results indicate that lymphoid hyperplasia in the large intestine may be associated with allergic airway diseases rather than with food allergies; thus, its presence may be useful to detect patients with underlying airway hyperreactivity.

Atopic allergy resulted from exposure to HDM allergens in Amara city: southern Iraq

House dust mites (HDM) are small creatures that live indoor in warm, moist places. Several studies found that HDM are important sources of airborne allergens that cause different allergic symptoms all over the world. With this mind, 200 persons suffering from different allergic symptoms were randomly selected in the current study aged between 7-60 years old from both gender. They all subjected to skin prick test by using standard allergen solution for HDM allergens Dermatophagoides farinae (D.F) and Dermatophagoides pteronussinus (D.P). The results showed that most frequent allergic disease related to exposure to HDM was asthma and allergic bronchitis(33 % and 28% respectively). Female sex have the higher percentage of response(61%) than males(39%). Also, the urban society were more sensitive than rural. Furthermore, workers were more allergic than employees. In conclusion: we observed that sensitization to HDM allergens is associated with airways allergy such as asthma and allergic bronchitis especially in females and workers. In addition the allergic symptoms increase with urbanization.

Pulmonary Disease Potentially Associated with Nicoletella semolina in 3 Young Horses

Pulmonary Disease Potentially Associated with <i><scp>N</scp>icoletella semolina</i> in 3 Young Horses

A Case of Chronic Cough with Progressive Breathlessness in a 32 Year-old Male Health Worker – Tuberculosis?, Allergic Bronchitis?, Asthma?

Introduction: Although tuberculosis is hyper-endemic in India and is responsible for a huge proportion of respiratory morbidity, adequate workup should be conducted to rule out other differential diagnosis wherever applicable. Case Report: A 32 year old male health worker was suffering from productive cough and gradually increasing breathlessness since three months. The investigations conducted were a sputum analysis and a chest x-ray, both of which were normal and hence he was treated as a case of allergic bronchitis. Subject presented to us after three months with no relief. We further investigated him and found severe eosinophilia in the peripheral blood, a positive anti-filarial antibody and a negative triple stool test for ova and parasites. He was treated with diethylcarbamazine and albendazole+ivermectin combination. The patient responded well and had no complaints at the end of the 4 week treatment. Discussion and Conclusion: The subject should have been evaluated by conducting a basic investigation like a complete blood count. Delay in treatment of cases of tropical pulmonary eosinophilia can lead to permanent respiratory morbidity.

Phospholipase A2 in Experimental Allergic Bronchitis: A Lesson from Mouse and Rat Models

BackgroundPhospholipases A2 (PLA2) hydrolyzes phospholipids, initiating the production of inflammatory lipid mediators. We have previously shown that in rats, sPLA2 and cPLA2 play opposing roles in the pathophysiology of ovalbumin (OVA)-induced experimental allergic bronchitis (OVA-EAB), an asthma model: Upon disease induction sPLA2 expression and production of the broncho-constricting CysLTs are elevated, whereas cPLA2 expression and the broncho-dilating PGE2 production are suppressed. These were reversed upon disease amelioration by treatment with an sPLA2 inhibitor. However, studies in mice reported the involvement of both sPLA2 and cPLA2 in EAB induction.ObjectivesTo examine the relevance of mouse and rat models to understanding asthma pathophysiology.MethodsOVA-EAB was induced in mice using the same methodology applied in rats. Disease and biochemical markers in mice were compared with those in rats.ResultsAs in rats, EAB in mice was associated with increased mRNA of sPLA2, specifically sPLA2gX, in the lungs, and production of the broncho-constricting eicosanoids CysLTs, PGD2 and TBX2 in bronchoalveolar lavage (BAL). In contrast, EAB in mice was associated also with elevated cPLA2 mRNA and PGE2 production. Yet, treatment with an sPLA2 inhibitor ameliorated the EAB concomitantly with reverting the expression of both cPLA2 and sPLA2, and eicosanoid production.ConclusionsIn both mice and rats sPLA2 is pivotal in OVA-induced EAB. Yet, amelioration of asthma markers in mouse models, and human tissues, was observed also upon cPLA2 inhibition. It is plausible that airway conditions, involving multiple cell types and organs, require the combined action of more than one, essential, PLA2s.

Amaranthus spinosus Linn. inhibits mast cell-mediated anaphylactic reactions

The current study characterizes the mechanism by which the Amaranthus spinosus (Amaranthaceae) decreases mast cell-mediated anaphylactic reactions. Anaphylaxis is a typical hypersensitivity Type I reaction, sharing common mechanisms with asthma in its early and late phases. Mast cells are key as effector cells in hypersensitivity Type I reactions. A. spinosus has been traditionally used in the treatment of allergic bronchitis and asthma, but its role in mast cell-mediated anaphylactic reactions has not fully been investigated. This report investigated the potential effects of the ethyl acetate fraction of A. spinosus leaves (EAFAS) against a Compound 48/80 (potent secretagogue)-induced systemic anaphylactic shock paradigm in a mouse model. In addition, rat peritoneal mast cells (RPMC) were used in in vitro studies to investigate the effect of EAFAS on Compound 48/80-induced peritoneal mast cell degranulation and histamine release. When administration by the oral route—1 h before Compound 48/80 injection—EAFAS (at dose from 0.001–1 g/kg) completely inhibited the induced anaphylactic shock. EAFAS at concentrations ranging 0.25–1 mg/ml dose-dependently attenuated rates of mast cell degranulation and histamine release from RPMC that were evoked by Compound 48/80. The results of the present investigation indicated that EAFAS stabilizes the mast cell lipid bilayer membrane, thereby preventing the perturbation of membrane and the release of histamine. As a result of these anti-degranulating and anti-histaminic effects, it can be suggested that EAFAS may have a potential use in the prophylaxis and management of anaphylactic reactions.

Pharmacokinetics of oral voriconazole in patients with cystic fibrosis

Sir, Aspergillus fumigatus may cause allergic bronchopulmonary aspergillosis (ABPA), aspergillomas or Aspergillus bronchitis in patients with cystic fibrosis (CF). Oral corticosteroids provide the mainstay of treatment for ABPA, but there are concerns about the side effects of long-term corticosteroid use. Itraconazole has been used as a steroid-sparing agent, but absorption in people with CF is poor and unreliable. Voriconazole, a broadspectrum triazole antifungal agent, may be useful for the management of fungal infections in people with CF. We undertook an open-label Phase IV pharmacokinetic study, which aimed to recruit 10 adults with CF, hospitalized for routine antibiotic therapy and with pancreatic insufficiency. Each subject received 400 mg of oral voriconazole (VFEND, Pfizer) 12 hourly on day 1, followed by 200 mg 12 hourly for the subsequent 13 days of the study. Venous blood samples were obtained for drug analysis pre-dose and at 1, 2, 4, 6, 8 and 12 h post-dose on days 1 and 14 of the study. Serum voriconazole levels were determined using liquid chromatography–tandem mass spectrometry. On days 1, 7 and 14, routine haematology, liver function tests and blood chemistry samples were taken. All suspected unexpected serious adverse reactions and serious adverse events were recorded. Data were expressed as the mean and standard deviation (SD). The maximum concentration (Cmax) and the time of maximum concentration (Tmax) were determined by visual inspection of the data. The area under the plasma concentration–time curve during the dosing interval (AUC0 – 12) was determined using trapezoidal summation. Determination of the elimination constant (kel) and half-life (t12) were undertaken using least squares non-linear regression of the experimental data (GraphPad Prism 5.02, GraphPad Inc., USA). The clearance for the fraction of drug absorbed (CL/F) for voriconazole was calculated as the dose/AUC0 – 12 ratio. The volume of distribution for the fraction of drug absorbed (V/F) was estimated as dose/(kel .AUC0 – 12). This study was approved by the Leeds (East) Research Ethics Committee. Regulatory approval was obtained from the UK Medicines and Healthcare products Regulatory Agency. Informed written consent was obtained from all subjects. Data were available from nine patients (seven males and two females). The study subjects had a mean percentage predicted forced expiratory volume in 1 s (FEV1%) (SD), percentage predicted forced vital capacity (FVC%) (SD) and weight (SD) of 38.7% (16.3%), 50.7% (17.1%) and 53.6 kg (7.1 kg), respectively. On day 1, the Cmax (SD) was 3.8 mg/L (1.6 mg/L) and occurred at 2.3 h (1.2 h). At the end of the study, the Cmax was 2.7 mg/L (0.8 mg/L) and occurred at 2.3 h (1.3 h) (see Figure 1). At day 14, all subjects achieved a peak serum voriconazole level of .1.0 mg/L and a trough level of .0.25 mg/L. The AUC0 – 12 (SD) was 24.0 h.mg/L (16.2 h.mg/L) and 15.5 h.mg/L (8.1 h.mg/L) on days 1 and 14, respectively. On days 1 and 14, the t1 2 (SD) for oral voriconazole was 8.0 h (5.8 h) and 5.4 h (3.4 h), respectively. The V/F (SD) was 200.8 L (82.1 L) and 100.3 L (48.2 L) on days 1 and 14, respectively. The CL/F (SD) was 26.2 L/h (19.0 L/h) and 14.9 L/h (8.2 L/h) on days 1 and 14, respectively. Three subjects withdrew due to side effects; two subjects due to visual disturbance on days 1 and 3 (both had peak levels .5 mg/L), and one on day 7 due to liver function test derangement. All symptoms resolved on cessation of voriconazole. Purkins et al. reported the V/F and CL/F for 200 mg of voriconazole orally to be 160.2 L and 19.9 L/h, respectively. The data from the present study would suggest that voriconazole has a higher volume of distribution, but slower clearance in patients with CF. Patients with CF are almost always pancreatic insufficient, resulting in poor absorption from the gastrointestinal tract, and may have an increased volume of distribution and faster drug clearance. Berge et al. documented 14% and 30% of patients with CF developed neurological and hepatic

A study on Vasantika Vamana (therapeutic emesis in spring season) - A preventive measure for diseases of Kapha origin

Panchakarma is the most essential part of Ayurveda treatments. It is preventive, preservative, promotive, curative and rehabilitative therapy. Ayurveda believes in strong relationship between macrocosm and microcosm and states that the seasonal changes will influence the biological systems resulting into the accumulation and aggravation of particular Dosha in a particular season like accumulation and aggravation of Kapha in Hemant Rutu (winter season) and Vasant Rutu (spring season) respectively, accumulation and aggravation of Pitta in Varsha Rutu (rainy season) and Sharad Rutu (autumn season) respectively. Vasantika Vamana is done in spring season approximately in the month of March and April for the elimination of vitiated Kapha Dosha which in turn helps to prevent the forth coming Kapha disorders and associated Pitta disorders or diseases originating or settled in the place of Kapha like bronchial asthma, allergic bronchitis, rhinitis, sinusitis, migraine, hyperacidity, indigestion, anorexia, obesity, overweight, dyslipidemia, diabetes mellitus, acne vulgaris, psoriasis, eczema, urticaria etc. In this study, a total of 89 persons were registered and 69 volnteers/patients undergone classical Vamana Karma without any major complications. Average minimum, maximum, total dose and total days of Snehapana were 36.40 ml, 187.21 ml, 578.59 ml and 5.01 days respectively. Average quantity of Madanaphala, Ksheera, Yashtimadhu Phanta and Lavanodaka was 5.81 g, 1130.29 ml, 3202.9 and 2489.13 ml respectively. The results were encouraging; hence, further studies may be conducted including large population in this direction.

Morbidity profile of steel pipe production workers

Objective:To study the different morbid conditions among steel pipe producing workers.Methods:The present cross-sectional study has been carried out among the workers of one of the steel pipes and tubes manufacturing factory of Gujarat. Hundred workers from the four major departments of the steel pipe production plant, namely welding, pressing machine, X-ray welding and loading/transportation department were covered. The information regarding demographic, occupational, clinical characteristics and diagnosis were recorded on a pre-designed proforma. Statistical analysis included calculation of percentages and proportions and was carried out using the statistical software Epi Info Version 3.3.2.Results:The mean age of the study subjects was found to be 38.7±7.1 years. The mean duration of exposure was found to be 9.0±3.4 years. Forty-four percent of the subjects had an upper respiratory tract infection, as evidenced by symptoms like dry cough, cough with rhinitis and cough with fever. Symptoms suggestive of allergic bronchitis were observed in 12% of the subjects while symptoms suggestive of heat stress such as prickly heat, dehydration, perspiration and pyrexia were observed in 13% of the subjects.

Pathological study of unexpected sudden death clustered in family or village in Yunnan province: report of 29 cases of autopsy

To investigate the pathological features and causes of sudden death clustered in family or village in Yunnan province so as to provide the morphological basis for exploring its etiology and medical intervention. Autopsy was performed on 29 cases of clustered in family or village in Yunnan province during the period 1991-2006, 16 males and 13 females, aged 32 (8-69), accounting for 10.2% of whole sudden unexpected deaths occurring in the same period. The heart, lung, liver, spleen, brain, kidney, intestinal tract, and other organs were examined macroscopically and histologically, including a study of cardiac conduction system in 5 cases. Pathological diagnosis of myocarditis was based on the Dallas Criteria and World Heart Federation's consensus while the histological evaluation of Keshan disease referred the China national guideline for pathological diagnosis of Keshan disease. Based on the main pathological changes and the causes of death, these cases were classified into seven groups (group A-G). Group A comprised 11 cases (38%) with lymphocytic myocarditis accompanied with focal myocardial necrosis or degeneration. Group B comprised 3 cases (10%) with neutrophil myocarditis accompanied with focal myocytolysis or coagulation necrosis. Group C comprised 4 cases (14%) with arrhythmogenic right ventricle cardiomyopathy in which fatty infiltration of myocardium was the only pathological finding. Group D comprised 2 cases (7%) with ischemic heart disease in which fresh or old foci of myocardial infarction were found but coronary stenosis was shown only in one case. Group E comprised 2 cases (7%) with left ventricle hypertrophy and obstructive muscle bundle in the outflow of left ventricle. Group F comprised 2 cases (7%) with allergic bronchitis or chronic bronchitis and pulmonary emphysema. Group G comprised the remaining 5 cases (17%) without any pathological finding that could explain sudden death. No cases suffered with Keshan disease and dilated cardiomyopathy. Focal but not diffuse inflammatory infiltration was the prominent histological feature of myocarditis in Yunnan cases. Among the five cases with histological examination of cardiac conduction system, 2 cases were detected to suffer from acute hemorrhage in His bundle and its left branching site, and the atrioventricular node of 1 case was involved. Different pathological changes coexisted in 4 pairs of family members as a cluster of sudden deaths. 3 of 4 first deaths had focal myocarditis and the other one had chronic infection. But 3 secondary deaths had myocardial ischemia and the other one had arrhythmogenic right ventricle cardiomyopathy. Pulmonary edema, acute respiratory infection and congestive or ischemic liver necrosis were found in some cases simultaneously. The pathological changes of the cases of clustered sudden death in Yunnan province are various, such as myocarditis, myocardial dysplasia and the other lethal heart-lung disorders. No case of Keshan disease has been found. Arrhythmogenic right ventricle cardiomyopathy and other foundational heart diseases might act as a background. It is very hard to contribute only one etiological factor to the clustering of sudden death in Yunnan. It was most likely that multiple factors cluster and trigger an outbreak of death in a definite time and space.

Pilot study: prevalence of positive aeroallergen reactions in 10 cats with small‐airway disease without concurrent skin disease

The purpose of this study was to determine the prevalence of positive allergen reactions in cats with small-airway disease (i.e. 'feline asthma', 'feline allergic bronchitis', 'feline bronchial disease'). Intradermal skin tests (IDT) and serum immunoglobulin E (IgE) tests were performed in 10 cats with idiopathic small-airway disease and in 10 normal cats without a history of respiratory disease. None of the cats had a history of skin disease or clinical signs of skin disease at the time of testing. Significantly more individual positive allergen reactions were found on serum IgE tests than on IDT in both groups of cats. Affected cats had significantly more individual positive allergen reactions on both tests than unaffected cats. Both IDT and serum IgE tests resulted in more individual positive allergen reactions to weeds, trees, grasses, and/or moulds in affected cats than in normal cats. Significantly more positive allergen reactions to house dust mites were found in affected compared to non-affected cats by IDT but not by serum IgE testing. One unexpected obstacle to inclusion of more affected cats in the study was the concurrent presence or history of suspect or known allergic skin disease. Concurrent allergic skin disease has not been reported in association with small-airway disease in cats. The increased prevalence of individual positive allergen reactions in affected cats may be due to increased immunological reactivity in these cats. Further studies are needed to answer this question and to determine what role, if any, aeroallergens have in the pathogenesis of this complex feline disease.

Tryptase Increases Proliferative Activity of Human Conjunctival Fibroblasts through Protease-Activated Receptor-2

Tryptase that is released by mast cell degranulation has recently been thought to play a key role in wound healing in allergic bronchitis. Conjunctival fibroblasts secrete mediators and extracellular matrices that could exacerbate inflammation and papillary formation in allergic conjunctivitis. This study was conducted to investigate the effect of tryptase on the proliferation of conjunctival fibroblasts and studied whether this effect was mediated by protease-activated receptor (PAR)-2. Conjunctival fibroblasts were cultured with or without tryptase (0.1 ng/mL to 1.0 microg/mL), and the proliferation rate was assessed after 48 hours. The effects of tryptase inhibitors (leupeptin, benzamidine) and a PAR-2 agonist (SLIGKV) were examined. The existence of PAR-2 mRNA and protein in conjunctival fibroblasts was examined by RT-PCR and Western blot analysis, respectively. The existence of PAR-2 in cultured conjunctival fibroblasts and conjunctival papillae from patients with vernal keratoconjunctivitis, as well as conjunctival tissue from normal subjects was examined by immunohistochemistry. Conjunctival fibroblast proliferation was upregulated by tryptase in a dose-dependent manner (P < 0.001). Leupeptin and benzamidine inhibited tryptase-induced fibroblast proliferation (P < 0.05), and SLIGKV mimicked tryptase's effect. PAR-2 mRNA and protein were detected in cultured conjunctival fibroblasts using RT-PCR and Western blot analysis. PAR-2 immunoreactivity in both the cultured conjunctival fibroblasts and in stromal cells in excised conjunctival tissues was observed. Tryptase increased conjunctival fibroblast proliferation and this response appeared to be mediated by PAR-2. Mast cells are the most likely source of tryptase in the conjunctiva and may play an important role in chronic exacerbations with conjunctival papillary formation in allergic conjunctivitis.

Treatment of ovalbumin-induced experimental allergic bronchitis in rats by inhaled inhibitor of secretory phospholipase A2

The pathophysiology of asthma involves the action of inflammatory/allergic lipid mediators formed following membrane phospholipid hydrolysis by phospholipase A(2) (PLA(2)). Cysteinyl leukotrienes are considered potent inducers of bronchoconstriction and airway remodelling. Ovalbumin (OVA) induced bronchoconstriction in rats is associated with increased secretory PLA(2) (sPLA(2)) activation and cysteinyl leukotriene production, together with suppression of cytosolic PLA(2) and prostaglandin E(2). These processes are reversed when the animals are pretreated systemically with an extracellular cell impermeable sPLA(2) inhibitor which also suppresses the early allergic reaction to OVA challenge. In this study we examine the capacity of the sPLA(2) inhibitor to ameliorate inflammatory and allergic manifestations (early and late bronchoconstriction) of OVA induced allergic bronchitis in rats when the inhibitor was administered by inhalation to confine it to the airways. Rats sensitised with OVA were treated with the sPLA(2) inhibitor hyaluronic acid-linked phosphatidyl ethanolamine (HyPE). The rats were divided into four groups (n = 10 per group): (1) naïve controls (no sensitisation/no treatment); (2) positive controls (sensitisation + challenge with OVA inhalation and subcutaneous injection of 1 ml saline before each challenge; (3) sensitisation + challenge with OVA and HyPE inhalation before every challenge; and (4) sensitisation + challenge with OVA and treatment with subcutaneous dexamethasone (300 mug) before each challenge as a conventional reference. Another group received no treatment with HyPE during the sensitisation process but only before or after challenge of already sensitised rats. Pulmonary function was assessed and changes in the histology of the airways, levels of cysteinyl leukotrienes in BAL fluid, and the production of nitric oxide (No) and tumour necrosis factor alpha (TNFalpha) by BAL macrophages were determined. Inhalation of HyPE markedly suppressed OVA induced early and late asthmatic reactions as expressed by bronchoconstriction, airway remodelling (histology), cysteinyl leukotriene level in BAL fluid, and production of TNFalpha and NO by BAL macrophages. OVA induced bronchoconstriction in sensitised non-pretreated rats was also inhibited by inhalation of HyPE either before or after the challenge. These findings confirm the pivotal role of sPLA(2) in the pathophysiology of both the immediate allergic response and the inflammatory asthmatic process. Control of airway sPLA(2) may be a new therapeutic approach to the treatment of asthma.

Experimental approaches to evaluate respiratory allergy in animal models

Asthma is defined as a chronic disease of the entire lung and asthma attacks may either be immediate, delayed or dual in onset. Allergic asthma is a complex chronic inflammatory disease of the airways and its etiology is multifactorial. It involves the recruitment and activation of many inflammatory and structural cells, all of which release mediators that result in typical pathological changes of asthma. A wealth of clinical and experimental data suggests that allergic asthma is due to an aberrant lung immune response mediated through T-helper type 2 (Th2) cells and associated cytokine-signaling pathways. The pathology of asthma is associated with reversible narrowing of airways, associated with prominent features that involve structural changes in the airway walls and extracellular matrix remodeling including abnormalities of bronchial smooth muscle, eosinophilic inflammation of the bronchial wall, hyperplasia and hypertrophy of mucous glands. The primary objective of respiratory allergy tests is to determine whether a low-molecular-weight chemical (hapten) or high-molecular-weight compound (antigen) exhibits sensitizing properties to the respiratory tract. This may range from reactions occurring in the nose (allergic rhinitis), in the bronchial airways (i.e., allergic bronchitis, asthma) or alveoli (e.g., hypersensitivity pneumonitis). Current assays utilize several phases, viz. an induction phase, which includes multiple exposures to the test compound (sensitization) via the respiratory tract (e.g., by intranasal or intratracheal instillations), by inhalation exposures or by dermal contact, and a single or multiple challenge or elicitation phase. The challenge can either be with the chemical (hapten), the homologous protein conjugate of the hapten or the antigen. The choice depends both on the irritant potency and the physical form (vapor, aerosol) of the hapten. The appropriate selection of concentrations (dosages) both for the induction and elicitation of respiratory allergy appears to be paramount for the outcome of test. Endpoints to characterize positive response range from the induction of immunoglobulins, cytokine or lymphokine patterns in serum (or the lung) to (patho-)physiological reactions typifying asthma. None of the currently applied animal models duplicate all features of human asthma. Accordingly, the specific pros and cons of the selected animal model, including protocol variables, animal species and strain selected, must be interpreted cautiously in order to arrive at a meaningful extrapolation for humans.

Educational Program for Smoke‐Induced Respiratory Diseases in Brazilian Amazon: Assessing Knowledge About Asthma

Economic and cultural considerations underlie the forest clearing by burning that occurs in the Brazilian Amazon region. The prevalence of respiratory diseases markedly increases during the annual burning season. As part of a nongovernmental initiative to reduce forest fires, health professionals received updated training about respiratory diseases aggravated by smoke. The aim of the present study was to describe and evaluate this educational program. A total of 1500 health care professionals received theoretical and practical guidance. Some of the involved community health agents (CHA) and nurse technicians completed a questionnaire that assessed knowledge about asthma before and after training. Asthma was recognized as an inflammatory disease by 274 of 743 (36%) CHA and nurse technicians on the initial questionnaire compared with 542 of 684 (80%) on the final questionnaire (p < 0.0001). The concept that asthma and allergic bronchitis are the same disease was initially acknowledged by 250 of 743 (33%) CHA and nurse technicians compared with 671 of 684 (90%) after the training (p < 0.0001). The usefulness of bronchodilators was identified by 442 of 743 (60%) CHA and nurse technicians before the training vs. 497 of 684 (73%) after the training (p < 0.0001). Training significantly influenced knowledge about asthma in the group studied. The impact of this program on health care remains unknown.